Students and global health experts share their experiences working with communities.

Category: ‘Desola

Long days, short (summer) weeks…. Wrapping up a remote global health practicum

It’s hard to believe that my practicum experience is almost over and that the summer’s almost gone! I keep asking myself where all the time went. For my practicum experience, I have been working with UNC Gillings Zambia on the ARCH study. The goal of the ARCH study is to optimize birth outcomes in low-resources settings, by using household surveillance to gain a better understanding of the social and clinical factors that may affect pregnancy outcomes in women of reproductive age. I think that one of the best parts of the study is that it allows the study team to follow women of reproductive age, from preconception to at least one year after the end of their pregnancy, in the event that they become pregnant during the course of the study. In addition, the study also follows children under the age of 2, to gain a better understanding about factors that impact the health of young children. Thus far, I have learned quite a bit from the study, mostly related to the implementation of such a large-scale study.

One of the most important lessons that I have learned so far has been the importance of flexibility and being willing to adapt to a new situation. At the beginning of my practicum, my preceptor and I thought that it would be most helpful if I worked on developing standard operating procedures (SOPs) for various aspects of the study. As time progressed, it became clear that there were other aspects of study implementation that would be a better fit. As such, we have pivoted from working on SOPs to developing recruitment and training materials. It has been an interesting learning experience, thinking about how best to simplify the language from protocols, written for technical experts, to informationals that can be understood by study participants. I’ve also learned a lot about the seemingly small aspects of study implementation that I had only briefly thought about. As I’ve been charged with drafting some of the training materials and schedules, I find myself thinking about the most pertinent parts of the study protocols and how to engage study staff when they might have days’ worth of training in their future. All in all, it’s been a truly educational experience.

It might not come as a surprise that one of the most challenging aspects of the practicum experience has been my inability to meet most of the people that I’m working with in person. I have tried to keep in touch via email. My preceptor has also been wonderful, as we decided to meet on a weekly basis, just to touch bases. I think that the weekly meetings have been helpful and have provided more opportunity for direct feedback. At this point, we have talked about extending my practicum, but I still don’t think that I will be able to see the actual start of the ARCH study. That said, I plan to follow the study closely and look forward to learning more about the results of the survey.

Lastly, I’m looking forward to enjoying the last weeks of summer, prior to the beginning of the semester. I’m very excited about starting the second year and can’t wait to meet in person!

– ‘Desola

Global Health Practicum in the time of COVID-19

For most people, myself included, the pandemic upended our way of life, from the way we socialize to the way we work. Currently, I work as a pediatric surgeon, so prior to starting my MPH, I figured that I would have to find a practicum experience that would be flexible with regard to my work schedule; allowing me to meet my clinical responsibilities while fulfilling my practicum requirement. More importantly, I wanted an experience that would allow me to marry my research interest in access to prenatal care and neonatal outcomes in sub-Saharan Africa. For all these reasons, I was extremely excited when I got the opportunity to work with the UNC Gillings Zambia group which focuses on “improving public health, locally and globally.” Specifically, I was selected as a practicum intern for the Antenatal Care/ Postnatal Care Research Collective – Household Survey (ARCH), a multinational collaborative that aims to optimize birth outcomes in low resource settings. I don’t think that I could have asked for a better practicum opportunity, as it aligned perfectly with my interests.

In my role, I will be working to help with study start-up and implementation of a new longitudinal household survey of 5,000 households in Lusaka, Zambia. The goal of this survey is to gain a better understanding of the behavioral and reproductive health of women of reproductive age. Ultimately, the results from the study will provide estimates of the burden of maternal, newborn, and infant disease; and provide information regarding key risk factors and social disadvantages that contribute to adverse maternal and neonatal outcomes. I am excited to be part of this study, albeit in a small way, because I think we know little about factors related to preconception and antenatal care of women in resource-limited areas. This area of research is particularly important because I think better understanding will provide information not only regarding factors affecting maternal health, but also regarding the burden of birth defects and help to inform planning for and improving neonatal outcomes.

During my practicum experience, I will be working to develop training materials for field research staff and recruitment materials for study participants.  Over the last few weeks, I have been working on getting acquainted with the study protocol, and meeting key personnel for the study. I have also started working on some of the participant recruitment materials.  It has been really interesting having meetings on Zoom to discuss the study and its initiation. It has made me long more for in-person meetings, because I think that it would have been great to meet some of the people with whom I’d be working. I also think that it would have been an amazing opportunity to be on ground in Lusaka. I am still hoping that I will be able to visit the Zambia Hub in the future.  In spite of the challenges regarding not being in-person, I have been fortunate to have a preceptor who has been available and easily accessible.

There are number of things that I am looking forward to in my practicum. Firstly. I am looking forward to learning how to carry a research study from a concept, to one that is actualized in practice. I am also looking forward to developing the training schedule and materials that will be instrumental in initiating the study. I feel that this project will allow me to think critically about an important part of research study implementation, in which I have little experience. Lastly, I hope that this experience will provide opportunities to build relationships with researchers who have similar interests, in improving prenatal access to care and neonatal outcomes, in resource-limited settings.  As a physician who is interested in global surgery and research, my involvement will therefore provide me with the skills to develop study management tools, train research staff in international settings, and establish methods to monitor data quality. Given that the study is still in the early stages of implementation and initiation, I believe that I will gain valuable experience regarding the successful implementation of a research protocol.

Although I expect to have a busy summer, I’m planning on making the most of the sunny days by doing as much work as I can outside :).